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Title: Mothers Hospitalised for Breast Abscesses, MRSA Do Not Need Powerful Antibiotics
URL: http://www.pslgroup.com/dg/22A996.htm
Doctor's Guide
September 3, 2008

DALLAS -- September 3, 2008 -- Many nursing mothers who have been hospitalised for breast abscesses are afflicted with methicillin-resistant Staphylococcus aureus (MRSA), but conservative treatment can deal with the problem according to new research presented in a study in the September issue of Obstetrics and Gynecology.

The study focused on hospitalised women with mastitis, and showed that community-associated MRSA was much more likely to be found in those who had both mastitis and abscesses.

The study was designed to determine how mastitis with and without abscess formation responded to different antibiotic treatment.

"The take-home message is that not every patient with mastitis necessarily needs an antibiotic against MRSA," said lead author Irene Stafford, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas.

"She will improve with a less specific antibiotic as long as she also empties her breasts, either through feeding or pumping, and if there's an abscess, gets it treated."

The study involved 136,459 women who delivered at Parkland Memorial Hospital, Dallas, Texas, between 1997 and 2005. Of those, 127 were hospitalised with mastitis.

The researchers found that about 59% of the women with both mastitis and abscesses had MRSA, while only 2% of women with mastitis alone had MRSA. Because the study tracked only women who had been hospitalised, there is no way to know whether this proportion is the same in women treated for mastitis on an outpatient basis.

The study also showed that if a nursing mother has mastitis or an abscess caused by MRSA, she does not immediately need antibiotics against MRSA unless the infection does not respond to conventional antibiotic therapy.

Treating all mastitis or breast abscesses immediately with powerful drugs that fight MRSA carries a risk of creating even more antibiotic-resistant strains of staph, said Dr. Stafford.

"The physician can take the time to test the patient to determine what kind of bacteria she has," said senior author George Wendel, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center. "We found that you're not going to put the patient at a disadvantage if you start her on traditional antibiotics while you wait for culture results."

MRSA is resistant to many antibiotics, but the researchers found that even in cases when the exact cause of the mastitis or abscess had not yet been determined, and the women initially received antibiotics that shouldn't eradicate MRSA, all eventually recovered completely.

SOURCE: University of Texas Southwestern Medical Center

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